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目的观察和分析原发性肾病综合征(PNS)的患儿脂质紊乱与尿β2-微球蛋白(β2-MG)间的关系,探讨高脂血症对PNS患儿肾小管功能的影响。方法检测广东省东莞市人民医院儿科1997年1月至2004年11月就诊的132例PNS患儿血脂及尿β2-MG水平。并将患儿随机分成治疗组与对照组,均予综合治疗,治疗组加服血脂康降脂治疗4周,比较治疗前后及两组间血脂与尿β2-MG的水平变化。结果(1)132例PNS患儿尿β2-MG质量浓度均有不同程度升高,与胆固醇(TC),甘油三酯(TG),低密度脂蛋白(LDL),极低密度脂蛋白(VLDL)呈正相关(P<0.05)。(2)降脂治疗4周后,治疗组血脂与尿β2-MG水平与对照组比较差异有显著性意义(P<0.01)。(3)治疗组的PNS患儿尿β2-MG随血脂下降而下降,治疗前后尿β2-MG差异有显著性意义(P<0.01)。结论PNS患儿脂质紊乱与尿β-MG关系密切,肾病综合征患儿高脂血症是损害肾小管功能的因素之一。
Objective To observe and analyze the relationship between lipid disorder and urinary β2-microglobulin (β2-MG) in children with primary nephrotic syndrome (PNS) and to investigate the effect of hyperlipidemia on renal tubule function in children with PNS. Methods The levels of serum lipids and urine β2-MG in 132 children with PNS who were admitted to Pediatric Department of Dongguan People’s Hospital of Guangdong Province from January 1997 to November 2004 were detected. The children were randomly divided into treatment group and control group. All patients were treated with combination therapy. The treatment group was treated with lipid-lowering therapy for 4 weeks, and the levels of serum and urine β2-MG were compared before and after treatment. Results (1) The urinary β2-MG concentrations in 132 PNS children all increased to some extent, and were significantly correlated with the levels of cholesterol, triglyceride, low density lipoprotein (LDL), very low density lipoprotein ) (P <0.05). (2) After 4 weeks of lipid-lowering treatment, there was significant difference between the treatment group and the control group (P <0.01). (3) The urinary β2-MG of the PNS children in the treatment group decreased with the decrease of the blood lipid, and the difference of urinary β2-MG before and after treatment was significant (P <0.01). Conclusion There is a close relationship between lipid disorders and urinary β-MG in children with PNS. Hyperlipemia is one of the factors that impair renal tubular function in children with nephrotic syndrome.